What to Expect When Having an Intrauterine Device (IUD) Inserted

When you are making a decision about contraception, your clinician will ask you certain questions about your medical, contraceptive and sexual history. You should answer these questions honestly so that your clinician can help you decide if an intrauterine device (IUD) is right for you. An IUD is a device that is placed in the uterus, where it prevents pregnancy. Two IUD's are on the market in the United States. One contains copper and the other contains the female hormone progesterone.

Best Candidates for an IUD

The best candidates for an IUD are women who:

  • have a normal uterus
  • don't have any genital tract infection or sexually transmitted diseases (STDs) now or within the past 3 months
  • Have a low risk of STDs (in a long-term, steady relationship with one partner who has no infections)

IUD Insertion

The process of having an IUD inserted takes only about 5 to 10 minutes. The clinician will perform a pelvic examination to measure the size, shape and position of your uterus and reproductive organs. Next, the clinician will apply an antiseptic solution to your cervix.

Your clinician will insert the IUD up through the opening of your cervix into the uterus (womb). The IUD is put inside using a special applicator that holds it flat and closed until it reaches the top of the uterus.

At this point during the procedure, most women feel cramping; however, most women describe the cramping as mild to moderate, not severe. After the device is inserted, the string at the end of your IUD will be cut short enough to allow you to feel it and to periodically check that it remains safely in place.

After the IUD is inserted, your clinician or counselor will review some follow-up instructions with you. After your next period, it's a good ides to check to be sure that you can feel the IUD string.

Normally the string hangs about 2 inches down from your cervix into your vagina. Anytime you (1) cannot feel the string with your finger or (2) can feel the plastic part of the device, it means your IUD may have slipped out of place. If you have any doubts about the presence or position of your IUD, use an additional contraceptive (such as latex condoms with vaginal foam, cream or jelly) and call the office or clinic for instructions or an examination.

Some Women Have Pain or Nausea Immediately After IUD Insertion so You May Want to Bring a Family Member or Friend With you to the Office or Clinic.

Check for the IUD string after each menstrual period and any time you feel abnormal cramping during your period. At no time should you or your partner be able to feel the IUD during intercourse.

In most cases, you should have a check-up about a month after having an IUD put in. During this appointment, your clinician will make sure the IUD is in the right place and that you have no pelvic infection. After that, the IUD should be checked by a clinician once a year.

Common Side Effects

Most women have little discomfort wearing an IUD; however, it can take time for your body to adjust to an IUD. Uterine cramps (like menstrual cramps) or low backache might occur at the time of insertion, and occasionally might last for a few weeks after insertion.

The copper-containing IUD may cause heavier bleeding or cramping with your menstrual period. This is likely to get better with time. An over-the-counter pain reliever, such as naproxen or ibuprofen, is usually enough to control discomfort.

IMPORTANT SAFETY REMINDERS

  • Your IUD is designed ONLY to keep you from getting pregnant. It will not protect you from catching ANY sexually transmitted diseases.
  • If at any time you have a fever or chills with pelvic pain or tenderness, severe cramping, or unusual vaginal bleeding, contact your clinician because you may have infection.
  • There is a slightly increased risk of infection, called pelvic inflammatory disease (PID), during the first 3 weeks after IUD insertion. After that, the risk is very low.
  • If you or your partner are no longer mutually faithful, you are more likely to be exposed to sexually transmitted diseases. You should use an additional method like male condoms to protect against infection. In addition, you should talk to your clinician about whether another method of birth control might be more appropriate for you at this time.
  • Do not try to remove your IUD by yourself, and do let anyone else try to remove it. Only clinicians should do this.

Where You Can Get an IUD

  • Your doctor's office
  • Your nurse-midwife or nurse practitioner
  • Your local family planning clinic
  • The County or City Health Department